End stage renal disease (ESRD) is a disabling condition that unduly affects black families, particularly the one in three black female family caregivers that our preliminary research shows experience significant depressive symptoms. Our long-term goal is to develop effective, customized, and culturally-relevant interventions that optimize family caregiver mental and physical health status in under represented groups. The specific aims that guide this study are to 1) examine the efficacy of a cognitive behavioral therapist facilitated intervention (INSIGHT) in improving depressive symptoms (depressive symptom scores, hopelessness, anxiety, and self-esteem; and 2] determine if improvements in depressive symptoms are associated with improved functioning in black female caregivers of persons diagnosed with ESRD receiving INSIGHT Therapy. We base these aims and associated hypotheses on 1) published studies documenting the efficacy of this intervention in white women and 2) unpublished clinical data supporting its clinical utility in women of color. Over a 3-year period we will conduct a randomized phase-ll placebo-control, clinical-trial to test the efficacy of this 12-week therapist-facilitated cognitive behavioral treatment in a sample of 72 black female caregivers of persons with ESRD (treatment=36, control=36). We will enroll into the study black female caregivers who self-report at least mild depressive symptoms during the screening interview. We will assess study outcomes (depressive symptoms, hopelessness, anxiety, self-esteem, and functioning) using established paper and pencil self-report questionnaires at baseline, at the end of the treatment, and 12 weeks after completion of the treatment. An intent to treat analysis will be conducted along with the analyses dictated by the study hypotheses for those caregivers who are assigned to the treatment group but drop out. A preplanned subgroup analysis with data from the treatment group will also be conducted to ascertain whether treatment duration is associated with better outcomes.